Food FARMacia Breaks the Link Between Food Insecurity and Obesity in Children
Food FARMacias could be one part of the solution to the nation’s growing food insecurity problem, according to a new study by pediatricians at Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian.
Food insecurity—or lack of enough healthy food for an active, healthy life—is not just an issue of hunger. Food insecurity prevents children from reaching their full potential physically, cognitively, and socially. Children who grow up in food-insecure homes are sick more often, recover from illness more slowly, and are hospitalized more frequently. And food insecurity can contribute to obesity because people who are food-insecure eat what is affordable and available.
The new study found that a Food FARMacia program—a mobile food pantry that allowed parents to choose their own selection of free and healthy foods—was associated with reduced food insecurity in families and had a measurable impact on children’s health by reducing childhood obesity risk factors.
“As pediatricians, we are encouraged to screen for food insecurity among our patients, but we don’t yet know what we can do in the clinic to help fix the problem,” says study leader Jennifer Woo Baidal, MD, MPH, the Florence Irving Assistant Professor of Pediatrics at Columbia University Vagelos College of Physicians and Surgeons and an attending physician at NewYork-Presbyterian Morgan Stanley Children's Hospital.
“Our study is the first to show that directly providing fresh and healthy foods through a mobile food pantry protects against childhood obesity among pediatric patients in households with food insecurity.”
Food stamps are not enough
Pediatricians often refer parents of families experiencing food insecurity to government nutrition programs (aka “food stamps”), which do help. But enrollment requirements and red tape mean many families can be dropped from the programs. And rising food costs reduce the value of benefits for those who do receive them.
To address the issue, hospitals and health care organizations have created a variety of new programs that connect families to resources, provide education about healthy food, or provide food or food vouchers to families in need.
“We don’t know which of these actually work, so it’s important that we evaluate programs to find the most effective interventions,” Woo Baidal says.
Food FARMacia reduces child obesity
The new study examined Food FARMacia, a mobile food pantry program for patients experiencing food insecurity. Food FARMacia was established by the Choosing Healthy Active Lifestyles for Kids (CHALK) program, a collaboration between NewYork-Presbyterian and the Department of Pediatrics at Columbia University College of Physicians and Surgeons in partnership with West Side Campaign Against Hunger (WSCAH).
Food FARMacia shoppers belong to food-insecure families whose children receive health care at NewYork-Presbyterian’s Ambulatory Care Network. The mobile pantries are operated by WSCAH, a pantry based in New York City that offers high quality food and navigation to food-related services and entitlements.
During the study period, eligible families could visit the mobile food pantries twice a month and receive a variety of fresh and healthy foods, including fruit, vegetables, beans, and whole grains.
The researchers compared childhood obesity measures in families who participated in the Food FARMacia program with similar families who did not.
After just six months, Food FARMacia families were already seeing benefits: childhood obesity outcomes declined by a clinically significant amount and household food security improved.
All the children in the study were under the age of 6 years, when a reduction in obesity is particularly important, says Dodi Meyer, MD, professor of pediatrics and vice chair of community health at Columbia University and director of community health at NewYork-Presbyterian/Columbia University Irving Medical Center.
“Children with obesity by that age are more likely to have obesity throughout childhood and into adulthood,” she says. “Having an impact at an early age can produce lifelong benefits.”
Why Food FARMacia works
The Food FARMacia program differs from most other food-insecurity programs by providing a large amount of fresh food—free—for the entire household. It also simultaneously lifts two barriers to accessing healthy food: lack of access in the neighborhoods where many food-insecure people live and high cost.
“There is still a gap in understanding the relationship between food insecurity and health outcomes,” says Woo Baidal. “Is it the different diet and feeding practices? Is it stress in the family? It’s really complicated.
"By providing food to the whole family, Food FARMacia may have a positive effect by impacting all these factors at once.”
The study results were published in Pediatric Obesity on March 20 in a paper titled “Association of a Primary Care-Based Mobile Food Pantry with Child Body Mass Index: A Propensity Score Matched Cohort Study.”
All authors (from Columbia University and NewYork-Presbyterian unless noted): Jennifer Woo Baidal, Ngoc Duong, Jeff Goldsmith, Chin Hur, Brianna N. Lauren, Ivette Partida, Alyson Rosenthal (West Side Campaign Against Hunger), Emma Hulse, Steven Shea, Ken Cheung, and Dodi Meyer.
This research was supported by the National Institutes of Health (grants K23DK115682 and R01MD014872), the Doris Duke Charitable Foundation (grant 2020127), and the Columbia Children’s Health Innovation Nucleation Fund.
Jennifer Woo Baidal, MD, also is inaugural director of the Pediatric Obesity Initiative in the Department of Pediatrics at Columbia University Vagelos College of Physicians and Surgeons and director of pediatric weight nanagement at Columbia University Irving Medical Center and NewYork-Presbyterian Morgan Stanley Children’s Hospital.